Mother-Father Distress, Accommodation, and Child Eating Disorder Behaviors: A Dyadic Perspective

Parental psychological distress and accommodating and enabling behaviors may represent maintaining factors of anorexia nervosa (AN). However, very few studies included both parents; their interdependence is unknown. Using a dyadic approach, this study aimed to examine the relationship between parental psychological distress and accommodation at the admission of their child to specialized eating disorder programs, and their observation of their child's eating disordered behaviors 1 year later. Ninety-one dyads of mixed-gender couples of parents of children and adolescents diagnosed with AN (M_age = 14.5 ± 1.5 years) were recruited from one of the five University Health Centers across the province of Québec, Canada. At admission, parents completed the Psychological Distress Index and the Accommodation and Enabling Scale for Eating Disorders. Furthermore, parents reported their child's anorexic behaviors 12 months later using the Anorexic Behavior Observation Scale. The dyads were nondistinguishable by gender, suggesting a similar pattern of associations for mothers and fathers. Path analyses guided by the actor-partner interdependence model revealed an indirect effect within each parent; higher parental psychological distress was associated with higher child's eating disordered behaviors at the 12-month follow-up through greater parental eating disorder accommodation. A partner effect was also found; when one parent experienced psychological distress, the other parent was more likely to engage in concomitant accommodating behaviors, which, in turn, was associated with a report of more child's eating disordered behaviors by this parent at the 12-month follow-up. These findings highlight the importance of a dyadic perspective in exploring parents' emotional states and behaviors toward children with AN.